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The Adolescent Discouragement Indicator (ADI) was developed to assess the Adlerian construct of discouragement. The 75-item ADI contains five subscales corresponding to the five life tasks specified in Individual Psychology and is specifically designed to pinpoint the area and degree of adolescent discouragement. Item selection was based on ratings by five prominent Adlerians and item correlation with subscale scores. Age and sex norms for the ADI were established on 225 females and 299 males 12 to 18 years of age. Findings indicate that female adolescents are less discouraged than male adolescents on all scales except the love scale and both sexes reported the least amount of discouragment on the love scale. The only significant difference among the age groups is between the 13-year-olds and the 15, 16, and 17-year-olds on the love scale. An internal consistency coefficient of .95, a 2-week test-retest coefficient of .89, and a 4-week test-retest coefficient of .92 indicates that the ADI is a reliable instrument. Negative and significant (p < .001) correlations between the ADI and Social Interest Index (Greever, Tseng, & Friedland, 1973) and between the ADI and the Social Interest Scale (Crandall, 1975) contribute to construct validity and support Adler's belief that discouragement and social interest are inversely related. Results of behavioral and academic comparisons on a sample of adolescent males (N=57) seem to indicate a link between behavior, academic performance, and levels of discouragement. Results of factor analysis and interscale correlations are presented. Implications for further research include continued validation using behavioral criteria associated with discouragement, refinement of the subscales and establishment of score ranges to indicate when an adolescent is considered discouraged.

This dissertation aims to elucidate the relationships between chronic illness, depression, and developmental assets among adolescents with chronic illness and co-morbid depression. Chapter One describes the current state of evidence on the intersections between chronic illness, depression, and adolescent development, and introduces Positive Youth Development theory and the Developmental Assets Framework. Chapter Two describes an integrative review synthesizing findings from 11 cohort studies examining relationships between depression or depressive symptoms and chronic illness-related disease control, self-management behaviors, illness-related morbidity, and quality of life among adolescents. Chapter Three describes a cross-sectional study comparing the number and types of developmental assets between adolescents with differing health statuses and examining relationships between assets and co-morbid depression using data from the 2016 National Survey of Children’s Health. Chapter Four describes a qualitative study exploring ways that developmental assets were discussed by 16 adolescents and young adults who lived with chronic illness and co-morbid depression during adolescence and uploaded videos to YouTube, a public video-sharing platform. Chapter Five summarizes key findings of this dissertation, outlines strengths and limitations, and discusses implications for future research, policy, and practice.

Collection of papers submitted to the Faculty of Medicine, University of Cape Town, in fulfilment of the requirements of Part III of the Degree Master of Medicine in Psychiatry. / The following five papers are included in this collection. Paper 1. Flisher AJ, Joubert G, Yach D. Mortality from external causes in South African adolescents, 1984 - 1986. South African Medical Journal 1992; 81: 77-80. Paper 2. Flisher AJ, Chalton DO. High school dropouts in a working-class South African community: selected characteristics and risk-taking behaviour. Journal of Adolescence (in press). Paper 3. Flisher AJ, Roberts MM, Blignaut RJ. Youth attending Cape Peninsula day hospitals. Sexual behaviour and missed opportunities for contraception counselling. South African Medical Journal 1992; 82: 104-106. Paper 4. Flisher AJ, Parry CDH. Suicide in South Africa. An analysis of nationally registered mortality data for 1984-1986. Acta Psychiatrica Scandinavica (in press). Paper 5. Flisher AJ, Parry CDH, Bradshaw D, Juritz J. Suicide in South Africa - seasonal variation. Acta Psychiatrica Scandinavica (to be submitted) .

As children approach adolescence, their communication relation&hip with their mothers and fathers undergoes significant transformation. Research has hitherto been conducted on family communication as an isolated variable. This study analyzed adolescent and parental perceptions of adolescent self-disclosure and relational satisfaction by adolescents and parents.

Contemporary cognitive psychology and neuroscience contend that learning across development is a dynamic process; that learning is flexible, adaptive, and context-dependent. Moreover, particular learning demands, capacities, and sensitivities to external (i.e., social, environmental, etc.) and internal (i.e., biological) influences change over the course of development, depending on specific developmental niches, or periods of unique specialization. Given these theoretical contexts, this dissertation examines developmental niche-relevant influences on learning at three different stages of development, such as social modulators (i.e., parental proximity, and caregiving-related early adversity) and neural mechanisms (i.e., neural dynamic network flexibility). Studies 1 and 2 consider the parent-child attachment relationship and tested associations between parental proximity and classical conditioning reward learning in toddlers utilizing a within-subject study design. Findings suggest parental proximity and presence had a significant effect on reward learning outcomes. However, effects varied as a function of age and order of the parental presence versus absence manipulation. Study 3 investigates the relationship between caregiving-related early adversity (crEA) in school-age children and implicit motor sequence learning (MSL), a form of basic learning. There was no difference in MSL between crEA-exposed and age-matched, non-crEA-exposed, comparison children. However, group differences in executive functioning (EF) were present. Findings illuminate the selective impact of early stress on higher-order functioning (i.e., EF), but not on possible underlying lower-level processes (i.e., basic learning). Lastly, Study 4 employed a novel approach to quantify brain network changes over the course of learning, dynamic network flexibility (DNF), to examine associations with learning on a probabilistic reinforcement learning task in a sample of adolescents who perform better on the task compared to adults. This study provides evidence that average whole brain DNF, and DNF of the striatum in particular, is associated with reinforcement learning in adolescents, as was previously found in adults. However, DNF did not explain better learning outcomes observed in the adolescent sample. Each study separately contributes to the growing knowledge of social and neural associations with learning abilities that are not exclusive to, but important for study-specific developmental niches. Taken together, this dissertation provides evidence in support of a dynamic systems theory of cognition and asserts that learning and behavior during development is a dynamic process that is dependent on social input, adaptive to early experiences, and is supported by flexible neural network architecture.

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